Impact of Vertical Integration in Workers’ Compensation

By Olesya Fomenko, Bogdan Savych

December 14, 2023 Related Topics: Access to Care, Fee Schedules, Medical Costs, Networks, Return to Work, System Overview, Utilization

As vertical integration of medical providers has increased over the last decade, this study examines how claim costs, disability duration, and the nature of care change when patients see newly integrated medical providers relative to non-integrated providers.

Supporters of vertical integration argue care can be delivered more efficiently and this translates into improved outcomes. Opponents argue that the rising concentration of medical providers may lead to higher payments for medical care, due to lack of competition, without improvements in outcomes. This study addresses these important issues.

The analysis focuses on care provided to workers in 34 states who suffered a work-related injury between 2012 and 2018. It covers the main specialties of medical professionals who treat a large share of workers with injuries, including physicians and non-physicians.

Impact of Vertical Integration in Workers’ Compensation. Bogdan Savych and Olesya Fomenko. December 2023. WC-23-49.

Video:

Copyright: WCRI

pdf download

pdf, 399KB

Reports are free for members.

If you are a member, please login here

.

*Temporary membership will allow you to download the study represented here

Research Questions:

  • Did workers who were treated by vertically integrated providers have higher medical payments per claim and longer duration of temporary disability?
  • Were the patterns and quantity of care impacted by the vertical integration status of the treating providers?
  • How did the impact of vertical integration vary across main groups of injuries?

Contact WCRI

To obtain your member login or to answer any questions or concern you may have, please contact us here.